Cognitive Behaviour Therapy: Outline of model

This section is to give an overview of different models, different therapeutic orientations and techniques
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Cognitive Behaviour Therapy: Outline of model

Post by maven » Sat Dec 22, 2007 1:05 am

An Introduction to CBT

Here are some notes on CBT which provide a brief outline of what happens during therapy sessions, and why. CBT here is referred to in relation to the treatment of depression and anxiety, although it has potential to treat a range of mental health disorders. This is by no means and exhaustive explanation, but more of a taster. Please feel free to suggest additions and amendments. Further readings and links to ClinPsy topics are provided at the end.

Background and Development of CBT
In 1960 Beck opened the depression research centre to research the use of therapy and a means to provide outcome measures by way of post-session interviews. His research concluded that therapists were traditionally picking up on biased and irrelevant material and missed client’s thought processes that were relevant to their problems. Beck decided to group these negative and automatic thoughts as being related to the Self, Future, and World (social and environment), calling this the Cognitive Triad. He felt that existing psychodynamic theory did not address the cognitive triad, compelling the inception of CBT.

The philosophical underpinnings of CBT are very aged. Buddhist schools of thought understood the role of perception in forming the view of the world, and the Ancient Greeks explored perceptually mediated thinking. Eptictetus stated that “Men are disturbed not by things but by the views which they take of them”.

There are 4 elements within CBT: Cognitions (thoughts, reasoning, memory, imagination), Behaviour, Emotions (feelings), and Physical Self (sensations), with all of these set within the context of a social and physical environment – CBT cannot ignore any one of these.

The relationship between events, perception and reaction can be illustrated with an example. If you were lying in bed at night and heard a crash downstairs, what would you think? How would you feel? What would you do? Would this be different if you had/didn't have a cat (or other pet)? Would it be different if there had been a spate of break-ins in the neighbourhood? The example is meant to illustrate that what you think affects how you feel and how you behave.

As you can see the cognitive interpretation is an important determinant of the consequential psychological state. However, feelings also bias thoughts. If a depressed person is walking down the high street and sees a friend who ignores them there is potential for the depressed person to see themselves as not worthy of conversation leading to low self esteem and avoiding social interaction. Similarly a person experiencing psychosis may interpret voices in a negative and scary manner. Similarly again, a person taking an exam and not performing well may attribute their lack of success to their own personal disposition rather than to external or situational factors. It is thus important to shift the locus of (thought) control to the external rather than internal, in an attempt to reduce (switch off) ruminations that contribute to the cycle of depression.

This forms the beginnings of the CBT intervention – can you think of an alternative way of thinking? E.g. the depressed person can wonder if the person even saw them, or show empathy to their friend in the street who might be having an off day. The person hearing voices might be able to interpret them in a non-threatening way, and the person taking exam might be able to attribute poor marks to family problems or a lack of sleep the night before their exam. The deeper depression is the more rigid and catastrophic thinking can become. Also in eating disorders, at very low weight physiological changes can cause overly rigid thinking, therefore CBT may be less effective or may need to be used in combination with medication.

One experimental study illustrates the primacy of negative thought processing: A selection of neutral and emotionally charged words were flashed upon a screen in front of participants for 500ms each – not long enough for the word to be read, but long enough for the semanticity (meaning) to be processed. When the words were presented in a subsequent testing session (displayed long enough to read properly) amongst words that were not presented in the first session, participants who were depressed were better able to recognise the words that were displayed previously if they were negatively charged, and similar results were found with people who were anxious (with anxiety charged words). Thus the emotional saliency of words is processed at a stage even before their full comprehension is possible.

The Cognitive Therapy Area of Intervention


With most mental health concerns, CBT is delivered at an individual level, dealing with thoughts, feelings and behaviours in the present. Thoughts are identified and then challenged, to make them more objective and rational. Little attention is given to the aetiology of the problems, to the systems they occur within, or the patterns of relationship that recur. Work is developing to enable personality disorders to be tackled with adapted forms of CBT, like Cognitive Analytic Therapy and Dialectical Behaviour Therapy.

Basic Steps in Cognitive Therapy
1. Notice negative emotions.
2. Be aware of negative automatic thoughts and non verbal images (Can make use of daily diaries).
3. Recognise the link between thoughts feelings and behaviour.
4. Examine evidence for and against negative automatic thoughts.
5. Search for alternative explanations.
6. Substitute more reality oriented interpretations for negative automatic thoughts (N.B. client’s reality is important).
7. Test these out in action and assess the outcome.
8. May need to identify underlying assumptions and core beliefs which predispose one to distort experience (effectively building new beliefs).

A Typical Course of Cognitive Therapy

1. Assess suitability for CBT:
:arrow: Look at willingness to look at thoughts and emotions
:arrow: Check that rapport is not potentially difficult
:arrow: Should not be dependant on substances
:arrow: Is there emotion avoidance?
:arrow: Is there a history of failed therapies? Would CBT be more suitable?
:arrow: Should not be psychotic
:arrow: Should not be in immediate crisis
:arrow: CBT may not work well with endogenous depression, but better with external depression, although there is weak evidence for such a distinction
2. Agree a problem solving list (a CBT therapist may view an impass at this stage as indicative of personality disorder)
3. Measure severity of symptoms (BDI or HAD inventory can be used regularly to identify baseline/improvement)
4. Agree a number of sessions
5. Each session begins with agenda setting
6. Set homework
7. Review homework at start of session
8. Socialise patient to CBT model
9. Introduce thought monitoring using diaries
10. Develop shared case conceptualisation
11. Frequent summaries used to check shard understanding
12. Patient is encouraged to develop thought challenging skills – Instructions given
13. Socratic questioning and guided discovery is developed

A Typical Session of Cognitive Therapy

1. Review patient’s state
2. Set agreed agenda (over 1 hour)
3. Review homework and issues arising
4. Focus on agreed topic: problems, negative automatic thoughts, alternatives
5. Summarise
6. Homework agreed, problem solving where necessary
7. Session feedback, how patient feels, clarification
8. Pressing issues put on next sessions agenda, risk assess, keep boundaries
9. End

Identifying and Challenging Negative Automatic Thoughts (NAT’s)

:arrow: In session
:arrow: Diary (daily)
:arrow: Link thought with mood
:arrow: Belief ratings
:arrow: What is the evidence?
:arrow: Alternate views
:arrow: Advantages and disadvantages
:arrow: Thinking errors

Behavioural Experiments to Test Positive Thinking
:arrow: Prediction
:arrow: Review evidence
:arrow: Test a [specific] prediction
:arrow: Review

Common Challenges about Cognitive Therapy:
Challenge 1 – CBT is all about the power of positive thinking. Response: This arises from influential work by Carnegie, which is only loosely based on CBT, but has tainted perception of the model.
Challenge 2 – CBT is a mechanistic “cookbook” therapy. Response: CBT is wholly client-focused and empathy is shown throughout therapy.
Challenge 3 – CBT focuses merely on symptoms and leaves underlying psychological or emotional problems alone. Response: Evidence shows long term changes as a result of CBT, and meta-analytical studies show CBT produce superior effect sizes compared to antidepressant medication.
Challenge 4 – CBT is simply a process of showing clients where their thinking is faulty or irrational. Response: This myth arises from Albert Ellis’ Rational Emotive Behaviour Therapy (REBT) videos where he sat there and openly criticised his client’s thinking in an obtuse manner to try and change thinking: “Why would you think that? That’s crazy I tell you! Completely crazy!! Etc etc. CBT has moved on from its predecessor REBT.
Challenge 5 – The cognitive therapist’s role is to act as a rational disputer of the clients erroneous thoughts. Response: The client is encouraged to challenge their own thinking.
Challenge 6 – The cognitive therapist does not consider the relationship itself to be of any significance. Response: Carl Rogers has developed a humanistic approach to the client/therapist relationship and this is commonly employed in CBT.
Challenge 7 – CBT is a directive and didactic process where the therapist points the client in the direction required. Response: Actually, CBT is client-led albeit within the [semi-flexible] structure of consecutive CBT sessions.
Challenge 8 – CBT is only useful for relatively simple and straightforward problems, such as panic disorder and uncomplicated depression. Response: Aaron Beck’s 1979 manual first applied CBT to depression and panic disorder and was considered a revolution. In 1986 CBT began to tackle anxiety, and in 1990 CBT began to tackle personality disorders, obsessive compulsive disorder and psychosis. The United Kingdom leads the world in the development of these novel applications. CBT has become the most evidence based therapeutic intervention. It can offer treatment that compares favourably even with medication. For example, when tranquilisers are prescribed for panic disorder, they become ineffective after 4 weeks, and lead to dependency. CBT can treat the same disorder in 6-8 weeks with little or no side effects.
Challenge 9 – CBT is only suitable for short term work and not for chronic and complex problems (e.g. the personality disorders) where long term therapy is indicated. Response: There is a growing interest in complex co-morbidity, and Dialectic Behaviour Therapy was developed as an offshoot for persistent personality disorders.

CBT for Depression
The concept of loss is important in depression, and changes of attachment have been shown to coincide with physical changes such as levels and effects of cortisol. Comparative psychological experiments assert the importance of status in groups and learning from experience. Depression is often characterised by the initiation of safety behaviours whereby different values are attached to people, events and resources. People who are depressed stop competing for resources and are risk averse, taking very few chances (which potentially could be beneficial).

Culture is also key in understanding mood. It is a relatively western way of thinking to have a focus on the subjective individual experience of happiness, rather than whether or not a person is able to fulfil their role in the community. R. Lealy also asserts the importance of economic depression, highlighting how the world’s richest nations for one reason or another exhibit far higher rates of depression in their populations. It is also important to tackle the maintenance factors in depression and to break the cycle of rumination. In terms of CBT, the brain is generally considered to have finite processing resources and it is important to free these resources from occupation by rumination and negative cognitive rehearsal as a result of NAT’s.

Thinking Errors
1. All-or-nothing thinking: You see things in black and white categories. For example, if your performance falls short of perfect, you see yourself as a total failure. You act as if people are either good or bad, and fail to see grey areas in between. You give things emotionally loaded labels (eg I’m a total loser).

2. Overgeneralization/Catastrophising: Taking one example and thinking it applies to your whole life. Predicting worst case scenarios as if they are the likeliest outcome. For example, you see a single negative event as a never-ending pattern of defeat.

3. Mental filter/ Disqualifying the positive: You focus on every negative detail and dwell on so that your view of everything becomes more negative. You reject positive experiences by insisting they "don't count" for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences.

4. Jumping to conclusions: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. This can include Mind reading where you guess other people’s thoughts and don't bother to check them out and The Fortune Teller Error where you anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact.

5. Magnification or minimization: You exaggerate the importance of negative things (such as your errors or someone else's achievement), or you inappropriately shrink positive things until they appear tiny (your successes or other’s imperfections).

6. Emotional reasoning: You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true." For example, thinking other people must think of you as an embarrassment if you have felt embarrassed.

7. Personalization: You see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible. For example, feeling the weather was bound to turn rainy once you decided to go to the beach.


Some Common Depressogenic Assumptions

“Unless I am loved, I cannot be happy”
“Unless I am successful in all areas, I am worthless”
“It’s shameful to show weakness”
“Unless I set the highest standards, I will be second rate”
“If I disagree, I won’t be liked”
“If someone dislikes me, it means I am not likeable”
“I should be happy all the time”
“If I do well, it’s probably a fluke, if I do badly, it’s entirely my fault”

Depression reduces motivation and activity levels, reducing the person’s opportunity to gain pleasure and mastery. Behavioural activation is shown to be highly effective in treating depression and forms an integral component of CBT:

1. Restore behavioural function to pre-morbid levels
2. Devise constructive activities and initiate cognitive rehearsal. What did you use to enjoy? Problem solving along the way
3. Reduce withdrawal
4. Challenge beliefs about capability
5. Enable hope satisfaction
8. Identify cognitions that have been established during reduced activity
9. Verbal challenges to negative beliefs are less effective than behavioural challenging
10. Help the person to learn that cognitive errors are a source of problems
11. Be aware of crippling effects of self-rejecting thoughts when inactive
12. Break the depressive cycle
13. Collaborate and plan
14. Activity scheduling around the notion of pleasure and mastery
15. Keep 2 weeks diary data before intervention, noting mastery and pleasure levels for each activity
16. Identify pleasure as achievable
17. Create exhaustive list of all things pleasurable
18. Devise new activity schedule for 7 days – get the patient to problem solve, work through potential road blocks
19. Doing it is the key!
20. Trying is more important than achieving
21. Encourage mastery and pleasure
22. Beware of selective inattention to pleasure, introduce Mindfulness (i.e. when going for a walk, take special note of the trees, colours, smells, pleasant sensations, and promote self-focus)
23. Introduce more demanding tasks
24. Be aware of minimisation and other thinking errors

CBT for Anxiety


Different Models for Different Anxiety Disorders
:arrow: Panic (Clark)
:arrow: Agoraphobia (Chambles, Hackman, & Salkovskis)
:arrow: Hypochondria (Salkovskis & Warwick)
:arrow: Generalised Anxiety Disorder (Wells)
:arrow: Obsessive Compulsive Disorder (Salkovskis)
:arrow: Social Phobia (Clark & Wells)
:arrow: Post Traumatic Stress Disorder (Clark & Ehlers)


Principles of Exposure and Maximising Efficacy

1. Be specific about exactly which negative predictions are being treated by any behavioural assignment, such as exposure to a feared situation
2. Establish belief ratings prior to exposure
3. Encourage longer rather than shorter exposure duration (at least 30 min)
4. Whenever possible, try to avoid sudden and unforeseen increases in exposure intensity
5. Practice as frequently as possible (at least twice weekly preferably daily)
6. Check that the patient is fully engaging in exposure, and not relying on covert avoidance in order to cope
7. Patient should experience some arousal, but not to a level that feels overwhelming
8. Exposure homework between sessions is essential
9. Monitor fear levels, reduction in physiological arousal, and behavioural avoidance
10. Record and monitor changes in negative beliefs in light of exposure and learning

Further Reading


Depression and Cognitive Therapy
Becks, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Theory of Depression. London: Guildford.
Blackburn, I. M. (1987). Coping with Depression. Edinburgh: Chambers.
Fennell, M. J. V. (198). Depression. In Hawton, K., Salkovskis, P. M., Kirk, & J., Clark, D. M. (Eds.). Cognitive Therapy for Psychiatric Problems: A Practical Guide. Oxford: Oxford University Press.
Fennell, M. J. V. (1999). Overcoming Low Self-esteem: A Self-Help Guide Using Cognitive Behavioural Techniques. Robinson Books.
Gilbert, P. (1992). Counselling for Depression. London: Sage.
Gilbert, P. (2000). Overcoming Depression: A Self-Help Guide Using Cognitive Behavioural Techniques. Robinson Books.
Hawton, K. & Kirk, J. (1989). Problem-solving. In Hawton, K., Salkovskis, P. M., Kirk, & J., Clark, D. M. (Eds.). Cognitive Therapy for Psychiatric Problems: A Practical Guide. Oxford: Oxford University Press.
Powell, T. (2000). The Mental Health Handbook. Winslow Press.
Williams, J. M. G., Watts, F. N., Macleod, C., & Matthews, A. (1997). The Psychological Treatment of Depression: A Guide to Theory and Practice of Cognitive Behavioural-Therapy. London: Routledge.

Anxiety and Cognitive Therapy

Beck, A. T., Emery, G., & Greenburg, R. L. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. New York: Basic Books.
Clark, D. M. (1986). A cognitive model of panic. Behaviour Research and Therapy, 24, 461-470.
Clark, D. M. (1988). Anxiety States: Panic and generalised anxiety disorder. In Hawton, K., Salkovskis, P. M., Kirk, & J., Clark, D. M. (Eds.). Cognitive Therapy for Psychiatric Problems: A Practical Guide. Oxford: Oxford University Press.
Powell, T. (2000). The Mental Health Handbook. Winslow Press.
Salkovskis, P. M. (1985). Obsessive-compulsive problems: A cognitive behavioural analysis. Behaviour Research and Therapy, 23, 5712-5830.
Skeketee, G. (1993). Treatment of Obsessive Compulsive Disorder. New York: Guildford Press.
Warwick, H. M. C., Clark, D. M. Cobb, A. M., & Salkovskis, P. M. (1996). A controlled trial of cognitive-behavioural treatment of hypochondriasis. British Journal of Psychiatry, 169, 189-185.
Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalised anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320.
Wells, A. & Clark, D. M. (1997). Social phobia: A cognitive approach. In Davey, D. C. L. (Ed.). Phobias: A Handbook of Description, Treatment and Theory. Chichester: Wiley.
Wells, A. (1997). Cognitive Therapy of Anxiety Disorders: A Practical Manual and Conceptual Guide. Wiley.

Cognitive Therapy Discussions on ClinPsy
Why is CBT such a dominant therapeutic model?
Are courses too CBT orientated?
Debate about the dominance of CBT
CBT in CAMHS and facilitating groups

Note: If you have a suggestion about how to improve or add to this wiki please post it here. If you want to discuss this post please post a new thread in the forum. There is information about the structure, rules and copyright of the wiki here.

Content checked by qualified Clinical Psychologist on 12/06/2019
Last modified on 12/02/2018
Last edited by maven on Sun Jan 20, 2008 6:28 pm, edited 4 times in total.
Maven.

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The fool thinks himself to be wise, but the wise man knows himself to be a fool - Shakespeare

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Post by Ruthie » Thu Feb 17, 2011 7:14 pm

Actually there are quite a lot of aspects of this wiki that are based on quite a simplistic understanding of CBT and that aren't really very accurate or helpful in my opinion.

I'll try to re-write it but don't have a lot of time at the moment. Am hoping Baa will help me out. Any other formally trained or training cognitive therapists around who would like to help??

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Post by baa » Thu Feb 17, 2011 7:16 pm

I have no life, but am itching to get stuck into this. I think I have a section on the myths floating around my gmail documents. So that wont be too difficult to edit.
At least I'm not as mad as that one!

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Post by miriam » Thu Feb 17, 2011 9:44 pm

Yeah, feel free.

The nature of a wiki is that it should be the best of our compounded experience, and evolve as the evidence evolves. It shouldn't just be a solo effort at a particular point in time.

With this wiki in particular, I seem to recall that the person who wrote it felt they had an authoritative understanding of the topic, but I don't think that panned out to be a realistic appraisal...
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Post by Ruthie » Thu Feb 17, 2011 11:35 pm

I'm sure Baa and I will work on it. Anyone else is free to join in. I wondered about splitting the wiki into a series of smaller wikis that might be easier to get a snap shot of different aspects of CBT and help us to make a start. This wiki covers a multitude of aspects of CBT but doesn't do any of them justice imho.

This is the list of possible mini-wikis I've come up with:

Beck's developmental model

CBT Myth Buster (by Baa - I've had a preview, it is fab - get on with it girl! :lol:)

Disorder specific models including:
-Depression
-Phobias
-GAD
-Panic
-Health anxiety
-Social anxiety
-PTSD
-OCD
-Eating disorders
-Developmental trauma
-Low self-esteem
-Psychosis
-Personality disorder
-Dissociative disorders
-Pain/physical health

Techniques including:
-Socratic questioning
-Thought challenging
-BEs
-Imagery
-Schema work (traditional Beck style)
-Jeff Young's schema therapy

Third Wave CBT including:
-Compassion
-MBCT
-ACT
-DBT

Other issues including:
-CBT supervision
-Using CBT formulations in consultation
-Using CBT formulations to inform risk assessment
-Interpersonal process issues in CBT
-Using metaphors in CBT
-CBT with children
-CBT with older adults
-CBT with people with learning disabilities
-CBT with people on the autistic spectrum
-Low intensity CBT (would be great of some PWPs/LIWs were up for writing this one?)
-Social and cultural issues in CBT

Any volunteers for any of those mini-wikis? I may write some of them because I'm thinking of creating some of my own handouts for clients at work, especially around psychosis and trauma issues, so that may be a go-er from my POV.

Ruthie

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Post by sally » Fri Feb 18, 2011 11:30 am

I would volunteer for the CBT with children mini wiki, but I'm aware of the fact that I volunteered to do another wiki and show no signs to getting around to that one either ( :oops: ) so anyone else feel free to jump in.

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Post by baa » Fri Feb 18, 2011 1:06 pm

I can do the disorder specific anxiety and depression ones, I should know about that sort of thing by now :lol:
At least I'm not as mad as that one!

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Post by miriam » Fri Feb 18, 2011 6:41 pm

Cool, that sounds like an excellent plan. If there is a core overview of CBT, and then linked from it a small library of CBT mini-wiki entries that would be awesome :D
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Post by h2eau » Sat Feb 19, 2011 2:39 pm

I am happy to put together the mini wiki on CBT for people with LD / ASD based on a couple of the existing threads I've contributed on this.
We deem those happy who from experience of life have learnt to bear its ills without being overcome by them ~ C.G. Jung

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Re: Cognitive Behaviour Therapy: Outline of model

Post by h2eau » Tue Feb 22, 2011 12:08 am

Wasn't sure if the mini wikis were going to be part of a bigger wiki, or separate items, so I've posted what I've put together here and it can be moved to wherever is appropriate :) This is just a start and I will add more when I get round to it.

CBT for people with a learning disability and/or autistic spectrum disorder

Cognitive deficit vs cognitive dysfunction
The main difference between CBT for people with learning disabilities and for those without is that the emphasis is more on cognitive deficit rather than cognitive dysfunction. Therefore, there will be a large psychoeducational component. The level you work at may also be a lot more concrete and you will probably need to use lots of labelling, repetition, practice and prompting due to the memory and executive functioning impairments associated with LD or ASD. It is also extremely useful to involve the person's family/carers/support workers as co-therapists so that they can practice anything learned outside of the therapy session, aiding generalisation to everyday life. Child CBT resources such as the Huge Bag of Worries or Think Good Feel Good can be useful too, but may need adapting. The main thing I think is to ensure that the formulation and intervention are meaningful to the person.

Importance of considering level of cognitive functioning, language and emotional literacy
You would need to make sure you were working at the correct cognitive level for the person (but that is no different than any other good CBT), within their zone of proximity. People with an LD often use fewer words for emotions and that is the same for people with Autism. So its a good idea to check that out. Generally referred to as emotional literacy. Is really important to have an idea of the person's level of learning disability (if applicable), language ability and their level of understanding of emotions and to tailor any intervention accordingly.

Working creatively using different mediums to reinforce and practice skill development
Generally I think it is important to work on the same theme through a variety of mediums: talking, if their language is up to it (and be aware that people with LD can 'pretend' to know what you are going on about so that the extent of their disability is not uncovered [the cloak of competence/handicapped smile]), getting creative with art, role play, lots of role play, modelling, supported experinces, which all helps with conserving and accommodating new ideas and behaviours, in order for change to be facilitated as you are inputting in a multi-sensory way.

Think about working creatively using symbols (e.g. from clipart, Boardmaker), pictures from magazines and photographs, videos (e.g. from soaps - these are really good as people are often displaying very extreme emotions!) and role playing. I would use lots of labelling of thoughts and emotions too and practical activities. However, you may find that some people find this extremely difficult and you need to be very creative with the activities you devise and how you socialise the person to the basic tenets of the model.

The emphasis is on repetition, psychoeducation, and working systemically with family/staff/carers to ensure the work is continued outside of the therapy setting. Training carers in the methods can be very useful and if you personalise it well to suit the individual's levels and needs then CBT can be an effective method for people with a mild learning disability and/or ASD. Autism has the additional problem of rigidity, over and above that of the rigidity in thinking other people do. But then there are some very rigid people that have got an IQ higher than 70 too.

Useful papers and resources

For working with adults with a learning disability and/or ASD:

Royal College of Psychiatrists report on psychotherapy and learning disabilites: http://www.rcpsych.ac.uk/files/pdfversion/cr116.pdf

- Stenfert Kroese et al (1997) Cognitive-Behaviour Therapy for People with Learning Disabilities

- Kirkland, J. Cognitive-behaviour formulation for three men with learning disabilities who experience psychosis: how do we make it make sense? British Journal of Learning Disabilities, 33(4), 160-165

- Sams, K., Collins, S., & Reynolds, S. (2006). Cognitive therapy abilities in people with learning disabilities. Journal of Applied Research in Intellectual Disabilities, 19(1), 25-33

- Stenfert Kroese, B. (1998). Cognitive-behavioural therapy for people with learning disabilities. Behavioural and Cognitive Psychotherapy, 26, 315-322

- Willner, P. (2005). The effectiveness of psychotherapeutic interventions for people with learning disabilities: a critical overview. Journal of Intellectual Disability Reseach, 49(1), 73-85

For working with children and young people with ASD, these might be interesting reading:

- Susan W. White, Thomas Ollendick, Lawrence Scahill, Donald Oswald & Anne Marie Albano "Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders", J Autism Dev Disord (2009) 39:1652–1662

- Karen M. Sze & Jeffrey J. Wood "Cognitive Behavioral Treatment of Comorbid Anxiety Disorders and Social Difficulties in Children with High-Functioning Autism: A Case Report", J Contemp Psychother (2007) 37:133–143

- Jeffrey J. Wood, Amy Drahota, Karen Sze, Kim Har, Angela Chiu & David A. Langer "Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial", Journal of Child Psychology and Psychiatry 50:3 (2009), pp 224–234

The Research Autism website has a useful summary of the literature on CBT and ASD and below are a couple of papers about CBT and Asperger syndrome:

- Anderson, S. & Morris, J. (2006). Cognitive behaviour therapy for people with Asperger syndrome. Behavioural and Cognitive Psychotherapy, 34(3), 293-303

- Hare, D.J. (1997). The use of cognitive-behavioural therapy with people with Asperger syndrome: A case study. Autism, 1(2), 215-225

With thanks to: choirgirl, Dr.Dot, h2eau, and sarahlb100 for their contributions.

Note: If you have a suggestion about how to improve or add to this wiki please post it here. If you want to discuss this post please post a new thread in the forum. There is information about the structure, rules and copyright of the wiki here.

Content checked by qualified Clinical Psychologist on xx/xx/20xx
Last modified by h2eau on 21/02/2011
We deem those happy who from experience of life have learnt to bear its ills without being overcome by them ~ C.G. Jung

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Re: Cognitive Behaviour Therapy: Outline of model

Post by Ruthie » Tue Feb 22, 2011 7:59 pm

Looks good - I'll make a wiki - feel free to expand and adapt!
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